Neck Imaging Guidelines

This policy covers neck imaging—including general and advanced modalities (CT, MRI, nuclear medicine) and use of a Clinical Decision Support Tool for diagnostic imaging of common neck symptoms and complexes (e.g., cerebrovascular/carotid disease, dysphagia, cervical lymphadenopathy, neck masses, malignancy, thyroid/parathyroid, salivary gland disorders, trachea/bronchus, recurrent laryngeal palsy, neck pain, sore throat/hoarseness). Major limitations require a prior pertinent clinical evaluation (detailed history, physical exam, labs and basic imaging such as radiography or ultrasound) before advanced imaging except for guideline-supported scheduled surveillance; atypical presentations require physician review, and specific modality/contrast cautions apply (e.g., avoid routine CT without/with contrast combinations, reserve MRI for select indications, and consider IV contrast effects on thyroid/RAI studies and salivary stones).

"CT Neck is usually obtained with contrast only (CPT® 70491)."